By PAULA TRACY, InDepthNH.org
CONCORD – The Executive Council unanimously approved $15 million in federal American Rescue Plan Act funds to purchase Hampstead Hospital, calling it the quickest fix and the best deal to address the emergency room boarding crisis for children in need of residential mental health care.
The need for child mental health care has more than tripled since the pandemic, said NAMI-NH and 25 children were waiting in emergency rooms for mental health care this week, said Councilor Cinde Warmington, D-Concord.
The council also unanimously approved some $4.7 in federal funds to partially make up for its rejection two weeks ago of $27 million for its vaccine program, with Republican councilors saying this money doesn’t have the same federal strings attached that concerned many constituents.
But health officials said there will be delays in a rollout of shots for kids when they become available with the rejection of the $27 million.
This meeting did not include the more than 100 protesters who attended the past two council meetings but got what they wanted with the 4-1 rejection of the $27 million in federal contracts on Oct. 13 with the four Republicans nixing the contracts.
They were concerned that the state would accept the money from the CDC with federal strings that might mean the state would have to impose federal vaccination mandates. It was an assertion that Gov. Chris Sununu and Attorney General John Formella rejected. Sununu called the language “boilerplate.” Nine people were arrested at the meeting two weeks ago.
Wednesday’s meeting at the Department of Environmental Services in Concord had far less of a police presence. Most of those attending were department heads who with along the council and many members of the audience were not wearing face masks.
The council also approved big raises in pay for child workers at the Division for Children, Youth and Families, along with a number of other departments where there are huge numbers of vacancies and low salaries compared to other states.
Hampstead No Quick Fix
Even with the expedited process for Hampstead Hospital becoming part of the system of state mental health care, it will be at least six to nine months to help alleviate the child mental health boarding crisis backlog, the council was told.
Responding to criticism from Democrats that the governor was selecting federal ARPA funds – which he said he would have rejected if he was in Washington as a U.S. senator – Sununu said he would tap the state’s general fund to pay for the hospital if ARPA for some reason denies the request to use COVID-19 funds to buy a private mental health hospital.
Sununu stressed that it was a good buy and comparatively quick solution to the critical need and the state’s rainy day fund is flush and could be tapped for this purpose. The licensed, 111-bed private mental health hospital for children on more than 100 acres in Southern New Hampshire, now has 45 in its care.
It could provide much more service for children statewide and become an 80- to 90- bed facility with specialty care options, said Lori Shibinette, commissioner of Health and Human Services. She said the process to buy Hampstead Hospital began several months ago when she heard it was looking for a buyer.
With it being the only inpatient care provider for children with mental health issues in the state “we have the potential to double the current capacity and also do specialty care,” including for young adults age 18 to 25 who are adults but possess a lack of maturity to be in the adult system.
Shibinette said there are a lot of very positive things about buying the hospital and bringing it into the state system.
If Hampstead were to sell to a private provider who may not serve children, the state would be without that care for youngsters.
It is still early, she noted.
The purchase and sales agreement is still being negotiated and then the state would need to contract with a private firm to provide services, which will have to come to the council for approval. This contract that was accepted was just to accept the federal ARPA money.
Shibinette said she would use a quick sole-source process to find a third-party vendor to operate Hampstead, taking months out of the normal request for proposals process but the state would engage a number of potential providers who would then need to staff and stand up the process.
Councilor Janet Stevens, R-Rye, said she was pleased with the contract and applauded the HHS’s efforts to bring it to the table.
She read a statement from the National Association of Mental Illness-NH that welcomed the news.
“While there are many questions, we believe this is a significant step forward,” the statement read.
Transition to state control could occur in the early part of 2022, Shibinette said, and “from there it is going to be what kind of beds and expansion will happen the first half of 2022.”
She said she expected a third-party partner would be in place to help provide that level of care and it would take six to nine months.
Councilor Ted Gatsas, R-Manchester, asked if there is a lease-purchase option to get things going sooner.
Shibinette said she does not see that increase in capacity happening before March 2022.
Shibinette asked the council to put aside previously expressed concerns about funding sole-source contracts.
“In a lot of ways I am really counting on the council, who has expressed their dislike for sole-source contracts,” because in this case, without using the standard RFP process it will “save time so we can get kids into the hospital as quick as possible.”
Sununu endorsed the deal for Hampstead and said there was not likely a better deal out there that could address the crisis so quickly.
Sununu was approached by state Rep. Joe Guthrie, R-Hampstead, before the meeting. Guthrie, who is also a selectman, said he was assured by the governor that there would be payments in lieu of taxes to the town, which would lose about $150,000 a year in tax revenue with a state purchase.
He noted Hampstead Hospital is a big taxpayer in the town of about 9,000 bordering Salem. Shibinette also noted in her remarks that the town will not lose any revenue.
Vaccination Help
About $4.7 million in ARPA funds for the state’s COVID-19 vaccination programs were unanimously approved, but Shibinette said the rejection of much more money – $27 million in CDC funds two weeks ago – will still have its negative impacts with a delay in vaccinations, particularly as the FDA prepares to approve vaccines for those aged 5-11.
The state has about 125,000 eligible children who could get vaccinated, once they are approved. There is an expectation that could happen as early as next week as an advisory board voted unanimously Tuesday, with one abstention, to support the Pfizer vaccine for that age group.
Shibinette said the CDC grant language, which the majority of the council rejected, will likely appear in other grants in the future.
“Are we going to continue to reject those funds?” Shibinette said, noting that would additionally add to a delay of care.
Regional health clinics were hoping for the $27 million.
“We will see plenty of vaccines in our state but the ability to get an appointment….will be delayed because we don’t have all the providers on board,” yet, Shibinette said.
Warmington, the sole Democrat who was the sole councilor to support the $27 million, said she applauded efforts to find backfill funds.
Reproductive Care
Pressed by Councilor Warmington on the impacts of the recent council denial of state reproductive contracts, including Planned Parenthood, Shibinette said she has concerns about the future in attracting doctors who might face incarceration for performing abortions and there are current “desserts” across the state for medical care where women have to travel great distances to get basic care.
She said the state is at a current disadvantage in attracting more reproductive care providers because of the riders in the state budget which limit abortion rights.
Contracts, Confirmations
Diane Martin of Deerfield has stepped down from the Public Utilities Commission. Confirmations included Rich Lavers for another term as deputy commissioner of the Department of Labor. He and George Copadis, commissioner, were credited by both the governor and Councilor Joe Kenney, R-Wakefield, for his work during the pandemic, particularly for protecting the state against fraud, which was less than 1 percent in New Hampshire and comparatively higher in other states.
Nominations included Jared Chicoine as commissioner of the new Department of Energy, chair, and Dan Goldner of Manchester to chair the Public Utilities Commission.
Big Raises
Big raises for everyone from DCYF child care workers to private plow drivers and corrections department mental health care providers were approved Wednesday as New Hampshire responds to substantial numbers of vacancies in those jobs.
Councilors were told the state is having trouble attracting workers because of comparably low pay.
Warmington warned that this could lead to a number of other departments and unions asking for raises and that this was not a process that would be ignored by other departments who are not getting these raises.
There are 36 vacant child protective positions at the Division for Children, Youth, and Families as of Sept. 1.
In an effort to recruit and retain staff, the department can now offer a 35 percent raise and for supervisors, an 8 percent hike in pay. That would still be less than the comparable pay in Massachusetts by 30 to 70 percent but if no raise, it would negatively impact children who come into contact with the DCYF, Shibinette wrote in requesting the raises.
The request came a week after a boy from Merrimack went missing for over a month and was found dead in Massachusetts. An investigation is underway by police, the department, and eventually the Office of Child Guardian.
DCYF officials told the council that the state has made strides in reducing the number of cases each caseworker at DCYF was dealing with over a year ago, but the vacancies are not being filled because of pay.
Added pay was also approved for private entities to supplement state plow drivers for the Department of Transportation.
It noted Massachusetts pays 60 to 100 percent more for such contracts and the added plow need is greatest in southern New Hampshire.
Also, the council addressed the 29 openings now for social workers in the Department of Corrections, which is constitutionally required for inmate health. They approved a 35 percent pay hike, which is estimated to cost the state $476,030 annually.
Home Heating Funds
The council approved $35 million in federal LIHEAP grants to help low-income people keep warm this winter, and get assistance through their regional community action programs. Home heating prices are expected to soar this winter and it is expected demand for fuel assistance will grow.
JPP Grants
The council approved almost $300,000 in grants to help market tourism through the Joint Promotional Program, including almost half of that to White Mountain Attractions.
Chambers of commerce in the Lakes Region, White Mountains, Portsmouth, Twin Mountain, the NH Campground Owners and Ski New Hampshire will also get in on the funds.
Laconia State School
The council now has a Realtor to market the former Laconia State School.
A contract with CBRE of Manchester to find buyers for the more than 200 acres was approved with new language after it had been tabled two weeks ago.
Councilor Kenney, said he attended the Laconia City Council meeting Monday and wanted to add some language that would memorialize and indicate there needs to be a collaboration with the city in its sale.
The proposals will need to address demolition of buildings, remediation and zoning issues the city has along with seasonal and recreational access.
Sununu said every day it is not on the tax rolls is hurting the city’s coffers. He added that Commissioner of Safety Bob Quinn has helped identify a location to relocate the Lakes Region fire mutual aid center which is currently located on the former Laconia State School property.
Charlie Arlinghaus, the commissioner of the Department of Administrative Services, assured that the city would be part of the negotiation for the sale.
